Read by QxMD icon Read

Thyroid hormones

shared collection
20 papers 25 to 100 followers
By Ehud Ur Professor and Head, Endocrinology, UBC, Vancouver
Camilla Virili, Alessandro Antonelli, Maria Giulia Santaguida, Salvatore Benvenga, Marco Centanni
Levothyroxine, a largely prescribed drug with a narrow therapeutic index, is often a lifelong treatment. The therapeutic efficacy of thyroxine may be marred by behavioral, pharmacologic and pathologic issues acting as interfering factors. Despite a continuous search for an optimal thyroxine treatment, a significant number of patients fail to show a complete chemical and/or clinical response to this reference dose of thyroxine. Gastrointestinal malabsorption of oral thyroxine represents an emerging cause of refractory hypothyroidism and may be more frequent than previously reputed...
November 23, 2018: Endocrine Reviews
Giampaolo Papi, Salvatore Maria Corsello, Alfredo Pontecorvi
OBJECTIVE: Thyroid-related emergencies are caused by overt dysfunction of the gland which are so severe that require admission to intensive care units (ICU) frequently. Nonetheless, in the ICU setting, it is crucial to differentiate patients with non-thyroidal illness and alterations in thyroid function tests from those with intrinsic thyroid disease. This review presents and discusses the main etiopathogenetical and clinical aspects of hypothyroid coma (HC) and thyrotoxic storm (TS), including therapeutic strategy flow-charts...
2014: Frontiers in Endocrinology
Eric Fliers, Antonio C Bianco, Lies Langouche, Anita Boelen
Patients in the intensive care unit (ICU) typically present with decreased concentrations of plasma tri-iodothyronine, low thyroxine, and normal range or slightly decreased concentration of thyroid-stimulating hormone. This ensemble of changes is collectively known as non-thyroidal illness syndrome (NTIS). The extent of NTIS is associated with prognosis, but no proof exists for causality of this association. Initially, NTIS is a consequence of the acute phase response to systemic illness and macronutrient restriction, which might be beneficial...
October 2015: Lancet Diabetes & Endocrinology
Trevor E Angell, Melissa G Lechner, Caroline T Nguyen, Victoria L Salvato, John T Nicoloff, Jonathan S LoPresti
CONTEXT: Thyroid storm (TS) is a rare but life-threatening manifestation of thyrotoxicosis. Predictive features and outcomes remain incompletely understood, in part because studies comparing TS with hospitalized thyrotoxic patients have rarely been performed. OBJECTIVES: Our objectives were to compare the diagnosis and outcomes in TS versus hospitalized compensated thyrotoxic (CT) patients and to assess differences in diagnostic classification using the Burch-Wartofsky scores (BWSs) or Akamizu (Ak) criteria for identifying TS...
February 2015: Journal of Clinical Endocrinology and Metabolism
Maguy Chiha, Shanika Samarasinghe, Adam S Kabaker
Thyroid storm, an endocrine emergency first described in 1926, remains a diagnostic and therapeutic challenge. No laboratory abnormalities are specific to thyroid storm, and the available scoring system is based on the clinical criteria. The exact mechanisms underlying the development of thyroid storm from uncomplicated hyperthyroidism are not well understood. A heightened response to thyroid hormone is often incriminated along with increased or abrupt availability of free hormones. Patients exhibit exaggerated signs and symptoms of hyperthyroidism and varying degrees of organ decompensation...
March 2015: Journal of Intensive Care Medicine
Gisah Amaral de Carvalho, Gilberto Paz-Filho, Cleo Mesa Junior, Hans Graf
Hypothyroidism is one of the most common hormone deficiencies in adults. Most of the cases, particularly those of overt hypothyroidism, are easily diagnosed and managed, with excellent outcomes if treated adequately. However, minor alterations of thyroid function determine nonspecific manifestations. Primary hypothyroidism due to chronic autoimmune thyroiditis is largely the most common cause of thyroid hormone deficiency. Central hypothyroidism is a rare and heterogeneous disorder characterized by decreased thyroid hormone secretion by an otherwise normal thyroid gland, due to lack of TSH...
June 2018: European Journal of Endocrinology
Sima Nazarpour, Fahimeh Ramezani Tehrani, Masoumeh Simbar, Maryam Tohidi, Sonia Minooee, Maryam Rahmati, Fereidoun Azizi
Context: Currently, there is no consensus on universal thyroid screening and levothyroxine (LT4) treatment of pregnant women with subclinical hypothyroidism (SCH) who are negative for thyroid peroxidase antibody (TPOAb-). Objective: We aimed to evaluate the benefits of LT4 treatment on pregnancy outcomes in SCH-TPOAb- women. Design: This study was conducted within the framework of the Tehran Thyroid and Pregnancy Study. A single-blind randomized clinical trial was undertaken in pregnant women who were SCH-TPOAb-...
March 1, 2018: Journal of Clinical Endocrinology and Metabolism
Avais Jabbar, Alessandro Pingitore, Simon H S Pearce, Azfar Zaman, Giorgio Iervasi, Salman Razvi
Myocardial and vascular endothelial tissues have receptors for thyroid hormones and are sensitive to changes in the concentrations of circulating thyroid hormones. The importance of thyroid hormones in maintaining cardiovascular homeostasis can be deduced from clinical and experimental data showing that even subtle changes in thyroid hormone concentrations - such as those observed in subclinical hypothyroidism or hyperthyroidism, and low triiodothyronine syndrome - adversely influence the cardiovascular system...
January 2017: Nature Reviews. Cardiology
Kerry J Welsh, Steven J Soldin
Hypothyroidism is a very common disorder worldwide, for which the usual treatment is monotherapy with levothyroxine (L-T4 ). However, a number of patients treated with L-T4 continue to report symptoms of hypothyroidism despite seemingly normal levels of thyroid-stimulating hormone (TSH), free-T3 (FT3 ) and free-T4 (FT4 ) measured by immunoassay. This review summarizes the limitations of the immunoassays commonly used to measure thyroid hormone levels and emphasizes the advantages of the role of liquid chromatography-tandem mass spectrometry (LC-MS/MS)...
December 2016: European Journal of Endocrinology
Sarah J Peterson, Elizabeth A McAninch, Antonio C Bianco
CONTEXT: Levothyroxine (LT4 ) monotherapy is the standard of care for hypothyroidism. OBJECTIVE: To determine whether LT4 at doses that normalize the serum TSH is associated with normal markers of thyroid status. DESIGN: Cross-sectional data from the US National Health and Nutrition Examination Survey (2001-2012) was used to evaluate 52 clinical parameters. LT4 users were compared to healthy controls and controls matched for age, sex, race, and serum TSH...
December 2016: Journal of Clinical Endocrinology and Metabolism
Simone De Leo, Sun Y Lee, Lewis E Braverman
Hyperthyroidism is characterised by increased thyroid hormone synthesis and secretion from the thyroid gland, whereas thyrotoxicosis refers to the clinical syndrome of excess circulating thyroid hormones, irrespective of the source. The most common cause of hyperthyroidism is Graves' disease, followed by toxic nodular goitre. Other important causes of thyrotoxicosis include thyroiditis, iodine-induced and drug-induced thyroid dysfunction, and factitious ingestion of excess thyroid hormones. Treatment options for Graves' disease include antithyroid drugs, radioactive iodine therapy, and surgery, whereas antithyroid drugs are not generally used long term in toxic nodular goitre, because of the high relapse rate of thyrotoxicosis after discontinuation...
August 27, 2016: Lancet
Zeina C Hannoush, Roy E Weiss
Thyroid hormone replacement therapy in patients following thyroidectomy for thyroid cancer, although a potentially straightforward clinical problem, can present the clinician and patient with a variety of challenges. Most often the problems are related to the dose and preparation of thyroid hormone (TH) to use. Some patients feel less well following thyroidectomy and/or radioiodine ablation than they did before their diagnosis. We present evidence that levothyroxine (L-T4) is the preparation of choice, and keeping the thyroid-stimulating hormone (TSH) between detectable and 0...
January 28, 2016: Rambam Maimonides Medical Journal
Zheng Feei Ma, Bernard J Venn, Patrick J Manning, Claire M Cameron, Sheila A Skeaff
CONTEXT: An inverse relationship between thyroglobulin (Tg) and urinary iodine concentration (UIC) has been found in children, potentially making Tg a viable blood marker of iodine status. The application of Tg in adults is unknown. OBJECTIVE: The objective of the study was to determine the efficacy of Tg to assess iodine status in adults. DESIGN: This was a randomized, double-blind, placebo-controlled, clinical trial. SETTING: The study was conducted in Dunedin, New Zealand...
April 2016: Journal of Clinical Endocrinology and Metabolism
Anne Krejbjerg, Lena Bjergved, Inge Bülow Pedersen, Allan Carlé, Nils Knudsen, Hans Perrild, Lars Ovesen, Lone Banke Rasmussen, Peter Laurberg
OBJECTIVE: To clarify which factors may influence the serum Tg level in an adult population and how this may affect Tg as a biomarker of iodine deficiency (ID). DESIGN AND METHODS: Two identical cross-sectional studies were performed before (C1a: 1997-98, n = 4649) and after (C2: 2004-05, n = 3570) the Danish mandatory iodine fortification (IF) of salt (2000). Additionally, a follow-up study of C1a was performed after IF (C1b: 2008-10, n = 2465). The studies took place in two regions with mild (Copenhagen) and moderate (Aalborg) ID before IF...
September 2016: Clinical Endocrinology
Stine Linding Andersen, Jørn Olsen, Peter Laurberg
OBJECTIVE: Methimazole (MMI) and propylthiouracil (PTU) are both associated with birth defects and may also rarely be associated with agranulocytosis and liver failure. The frequency of these side effects when antithyroid drugs (ATDs) are used in the population in general or in pregnancy remains to be elucidated. DESIGN: All individuals registered as the parent of a live-born child in Denmark, 1973–2008, were identified (n = 2 299 952) and studied from 1995 through 2010 for the use of ATDs...
April 2016: Journal of Clinical Endocrinology and Metabolism
Krzysztof C Lewandowski, Katarzyna Dąbrowska, Iwona Komorowska-Dudek, Andrzej Lewiński
BACKGROUND: Though compliance (or adherence) problems, as well as inappropriate levothyroxine (L-T4) intake (e.g. with meal, other drugs or certain foods that can significantly affect absorption) are very common, the issue is often either not mentioned or even frankly denied by patients. CASE PRESENTATION: We describe three cases of patients who presented with high TSH (ranging from about 30 to 200 mIU/l), with concomitantly either high, normal or low free thyroxine (FT4), despite treatment with high doses of L-T4...
2015: Thyroid Research
Pedro W S Rosário, Marina Carvalho, Maria Regina Calsolari
OBJECTIVE: The risk of progression of subclinical hypothyroidism (SCH) to clinical dysfunction is one of the factors considered in the decision to treat this condition. This study evaluated the natural history of SCH in women with TSH ≤10 mIU/l. DESIGN: This is a prospective study. PATIENTS: Two hundred and fifty-two women with SCH and TSH levels ranging from 4·5 to 10 mIU/l were followed up for a period of 5 years. RESULTS: Among the 241 patients followed up until the completion of the study, 46 (19%) required levothyroxine (L-T4) therapy, 55 (22·8%) had spontaneous normalization of serum TSH, and 140 (58·1%) continued to meet the criteria for mild SCH...
June 2016: Clinical Endocrinology
Aglaia Kyrilli, Bich-Ngoc-Thanh Tang, Valérie Huyge, Didier Blocklet, Serge Goldman, Bernard Corvilain, Rodrigo Moreno-Reyes
CONTEXT: Relatively low radioiodine uptake (RAIU) represents a common obstacle for radioiodine ((131)I) therapy in patients with multinodular goiter complicated by hyperthyroidism. OBJECTIVE: To evaluate whether thiamazole (MTZ) pretreatment can increase (131)I therapeutic efficacy. DESIGN AND SETTING: Twenty-two patients with multinodular goiter, subclinical hyperthyroidism, and RAIU < 50% were randomized to receive either a low-iodine diet (LID; n = 10) or MTZ 30 mg/d (n = 12) for 42 days...
June 2015: Journal of Clinical Endocrinology and Metabolism
Roberto Vita, Giovanna Saraceno, Francesco Trimarchi, Salvatore Benvenga
CONTEXT: Proton-pump inhibitors (PPIs) impair tablet levothyroxine (LT4) intestinal absorption by increasing the gastric pH and decreasing LT4 dissolution in the stomach. OBJECTIVE: The purpose of this study was to verify whether a liquid formulation of LT4 would correct LT4 malabsorption induced by PPIs. DESIGN: This was a prospective observational cohort study. The study was conducted from 2012 to 2013, and the mean duration of the follow-up was 23...
December 2014: Journal of Clinical Endocrinology and Metabolism
Bernadette Biondi, Leonard Wartofsky
Thyroid hormone deficiency can have important repercussions. Treatment with thyroid hormone in replacement doses is essential in patients with hypothyroidism. In this review, we critically discuss the thyroid hormone formulations that are available and approaches to correct replacement therapy with thyroid hormone in primary and central hypothyroidism in different periods of life such as pregnancy, birth, infancy, childhood, and adolescence as well as in adult patients, the elderly, and in patients with comorbidities...
June 2014: Endocrine Reviews
2014-06-15 16:48:26
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"